贲门周围血管离断术后上消化道再出血的原因分析和诊治

THE CAUSES AND TREATMENT OF UPPER GI REBLEEDING AFTER PERICARDIAL DEVASCULARIZATION

目的 :分析贲门周围血管离断术后上消化道再出血的原因 ,以提高诊断水平及治疗效果。方法 :总结 36例贲门周围血管离断术后上消化道再出血病人 ,对其出血原因、诊疗经过及其治疗效果进行回顾性分析。结果 :贲门周围血管离断术后上消化道再出血的原因依次为食管胃底曲张静脉破裂出血、胃粘膜病变出血和溃疡病出血。3 6例病人中 2 9例手术治疗 ,2 8例痊愈 ,1例死亡 ,7例保守治疗获痊愈。结论 :再手术治疗和保守治疗都能取得较好的效果 ,关键在于正确选择适应证。提倡断流的彻底性和适当保护肝功能、改善肝脏的微循环可望减少这些并发症。

Objective:Analyzing the causes of upper GI rebleeding after pericardial devascularization in order to enhance the diagnostic level and therapeutic effects.Methods:The causes,diagnoses,treatments and results were retrospectively analyzed in 36 patients with upper GI rebleeding after pericardial devascularization.Results:The causes of upper GI rebleeding after pericardial devascularization were esophageal varices,portal hypertension gastropathy,peptide ulcer in their given order,29 of 36 patients accepted re operation,28 were cured and 1 died.Other 7 patients who accepted conservative treatment were cured.Conclusion:Re operation and conservative treatment can all gain satisfactory effects,the key is to choose applicable patients rightly.Advocating complete pericardial devascularization,protecting liver function properly and improving liver microcirculation may decrease these complications.